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John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the most disappointing parts of HIMSS for me is that the really creative and disruptive innovations are missing from HIMSS. There are a few items I saw like the Shareable Ink technology, some of the Nuance NLP/voice recognition work, and a pretty cool biometric kiosk by Fujitsu (which I’ll blog about later). Sadly I wasn’t seeing the really creative innovation coming from the EMR companies (and I talked to a lot of them) at HIMSS. I think there’s two possible things at play in this regard.

First, meaningful use is probably largely to blame for much of the lack of innovation that I saw. As someone told me, the regulation of EHR software has damaged and deterred the innovation. I guess you could say I’ve seen some interesting and innovative ways to approach meaningful use, but being innovative in meeting a government regulation is not the innovation I want to see. I think it’s generally clear that EMR vendors have spent the last development cycle focused on EHR certification and meaningful use.

I asked one large EMR vendor about this idea and what innovations their EHR had available. I don’t think he was very comfortable with the assertion. In response, he described how at his EMR company, they had a team that was focused on EHR certification and the meaningful use requirements but that they also had a whole other group that was focused on customer’s needs and meeting those customer needs.

It’s incredibly interesting that so many EHR vendors responded to my innovation (or what differentiated them from other vendors) by playing the EMR usability or “Doctors like using our EMR” better card. That’s related to the above, we have a group that focuses on our customer’s needs.

Certainly focusing on customer requests and needs is vital. However, it seems fitting to mention the oft quoted, “If I asked my customers what they wanted, they’d have said a faster horse. – Henry Ford” Seems like HIMSS was just displaying the faster “horses” [EMR].

A second possibility is that maybe EMR software has become a commodity. Maybe the reason we don’t see that much innovation is because EMR software has now basically become a commodity. I certainly heard many EMR vendors suggest that EMR is basically a commodity service now and that many other factors will determine the success of the EMR company instead of the EMR software itself. I argue that once you reach a certain set of features, functions and successful installs that the software itself does become secondary to the success of most EMR companies. Does that mean EMR is a commodity?

The other angle that a few new EMR vendors are taking is that EMR is not a commodity. It’s just that all the current EMR software is junk. Most then like to compare EMR software to tablets. The Apple iPad came along and finally presented what amounts to an incredibly well thought out and designed tablet and is destroying the market. These new EMR vendors see their product as the innovative “iPad” of EMR software.

Only problem is that I have yet to see any EMR company have an iPad-onian moment.

I could easily argue that the iPad was the most marketed IT device on the HIMSS exhibit floor. Yet, an Apple booth was absolutely no where to be seen.

I wonder what kind of EHR could be so innovative and disruptive that it would be the talk of HIMSS even if they didn’t exhibit?

EMRandHIPAA.com’s HIMSS11 coverage is sponsored by Practice Fusion, provider of the free, web-based Electronic Medical Records (EMR) system used by over 70,000 healthcare providers in the US.

18 responses to "EHR Innovations Have Gone Missing at HIMSS11"

I guess you missed the real innovation. No other company on the trade show floor could demonstrate pen or dictation or transcription to a certified EMR (HDOX)via MedLEE NLP. No data entry required. Stop by our booth tomorrow and you will be impressed.

You may be right John; there may not be many of the sexy innovations such as IPAD or EHR on IPAD,etc., which we consider as more of sexiness than real functionality.
Having said that and working in the trenches, one of the many projects that some of us are working with ONC is the standardization of Lab Tests and Codes associated so that results can be compared across the 100+ labs in the country; and the interfaces become that much less expensive bor bi-directional data flow. Projects such as these are not jazzy; but provides that incremental functional improvment and these require time.
My quick thought………………

I spent most of my life being in various kinds of tech innovation, so I know what you mean. Having said that, I humbly submit that the innovation you seek was innovation that year after year failed to serve consumers (patients), as vendors (remember I was one) sought to entice their paying customers (the people who bought systems). I completely understand this, but the end result was that we consumers have been left out in the cold.

We also have volumes of complaints from system users (hospital workers) about the systems too often being hard to use, getting in the way of their work, etc. I’ve never used one but I’ve talked personally with many doctors about this.

If I understand correctly, what’s happening now is that the regulators have stepped in and said “Dude, you gotta serve the consumer.” I’m no fan of solving things by unnecessary regulation, but in matters like lead paint and toxic food, regulation turned out to be necessary. This situation is different, but it does appear that the sudden halt in other innovation indicates that the meaningful use rules are succeeding in shifting vendors’ focus.

I look forward to when hospitals HAVE to compete for patient business by having features patients like, so they in turn ask for those features from system vendors. The ecosystem will then function on its own again – with the vital difference that for the first time, it will include the people who live or die based on how well the products serve them. Imagine! :-)

Hi John,
Terrific meeting you at HIMSS11! I have a picture of us at the New Media Meetup that I still haven’t posted–will tweet it later–even though it’s too late to win the contest.

Re: lack of innovation at HIMSS11 and too much focus on meaningful use, I take a different view. I think MU directs resources toward adding content (data and applications) to EHR/EMRs that improve productivity of clinicians and providers (better quality, more efficiency). Cool technology is fun, but without apps, it doesn’t sell. The iPad is nothing without content and the iPod would not have been so successful without the iTunes store.

I look forward to new innovations that mash-up EHR s/w and data to create cool applications for clinicians, provider orgs, researchers, — and of course patients. My hope is that we see more apps for patients at HIMSS12.

John, new to the blog – but I can tell stealing those famous words “I’LL BE BACK” – good feeedback and as you said HIMSS is a big palce nad difficult to cover all the ground. I did see many wonderful Real Life applications of innovative technology at the Interoperable Showcase. Yes, a bit bias as I was fortunate to be in a Kiosk and based on reaction, clearly one that was innovative. Being able to remove the input device from the equation and embracing users of any level of digital inclination will enahnce adoption rate. By embracing dictation, writing, and typing concurrently and populating any form (RoverINK) with the results being a coded docuement and formatted C32. Updating a Natural Language Processor (MedLEE) in the work flow for semantic interoperablity as well as directly updating a Certified EHR (HDOX) certainly caught our audiences attention and in their words, “now that’s innovation!” I saw many other examples in the Kiosk’s that blew me away and after 30 years of technology, that is not easy to do. To all at CONNECT – Kudo’s

“Being able to remove the input device from the equation and embracing users of any level of digital inclination will enahnce adoption rate. By embracing dictation, writing, and typing concurrently and populating any form (RoverINK) with the results being a coded docuement and formatted C32. Updating a Natural Language Processor (MedLEE) in the work flow for semantic interoperablity as well as directly updating a Certified EHR (HDOX) certainly caught our audiences attention and in their words, “now that’s innovation!””

Of course, you’ll have to translate that for most people. I’d do it myself, but I’m still on the HIMSS 10 step recovery plan.

Thanks for coming by and I hope you will be back regularly. We need people like yourself sharing more stories. I’m happy to give those stories the platform to be heard.

Anthony,
Good thought. I’d also add something I’ve mentioned multiple times that we can’t realize the most powerful benefits of EHR until there’s wide adoption and interoperability. Then, we’re going to see some really interesting opportunities that we didn’t even see possible before.

e-Patient Dave,
I always appreciate you providing the patient angle in it all. Your voice is and will continue to be a valuable asset in the future of technology adoption in healthcare.

I’ve talked a number of times about patients driving doctors to adopt EMR software. Unfortunately, I haven’t found a really compelling argument that patients would make to demand this from their doctors in mass numbers. I’m still digging to find the reason why I would choose one doctor over another based on their EMR use. I’d love to hear your thoughts on this.

Interesting that you see the regulation as asking the doctors to serve the consumer. I think you and some other prominent voices have driven the need for the regulations to include the patient and that’s been beneficial.

Janice,
Post away. I’m going to do a follow up post with all the pics. I wish we’d had more chance to talk. I’m sure we will again some time in the future.

Lots of electronic content will be interesting. Look at what Watson was able to do with basically massive amounts of content.

I can guarantee that 2011 will include a plethora of apps for patients and for those of us who aren’t patients, but want to keep better track of our health.

Thanks everyone for reading and sorry about the slow response. Monday I’ll be back in business and recovered from the whirlwind fun that I had at HIMSS11.

[…] seems like EMR innovation has been a strong theme on EMR and HIPAA ever since I wrote about the lack of EHR innovation at HIMSS. I of course clarified my original post with this post on the future of MER and EMR innovation and […]

My position as a medical transcriptionists for 16 years at a hospital got outsourced to a transcription service, and we employees were offered jobs with that service. The hospital was told that their transcriptionists would be offered comparable employment with benefits. The line count set me back about 15 years as well as the “benefits package”. My former boss was not even aware of the true line count we were offered. The outsourcing service took advantage of the hospital and their employees. Most of us transcriptionists have quit working for the outsourcing company.

Diane,
I’m sorry to hear that. Business choices can leave a lot of good people in the wake. I’m sorry to hear that’s happened to you and likely many others in the transcription industry. It seems like the trend for transcriptionists is moving towards clinical documentation. So, an extension of the existing skills. What are your plans going forward?

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